Celiac Disease and Autoimmune Thyroid Diseases - Medicine Science

0 downloads 0 Views 360KB Size Report
Mar 31, 2014 - Abstract. Freshmen officer cadets in a military university participating in 6 weeks of induction undergo strenuous physical training. Vigorous ...
Medicine Science 2014;3(3):1479-90 Original Investigation

Hematologic Changes and Training doi: 10.5455/medscience.2014.03.8150

The Effect of 6-weeks Military Training on Blood Hematological Parameters in Untrained Recruits in a Military University

Justin Gnanou, Brinnell Caszo, Igor Khalin, Shahidah Leong, Victor Feizal Knight, Mohd Zin Bin Bidin Faculty of Medicine and Defence Health, National Defence University of Malaysia, Kem Sungai Besi 57000 Malaysia

Abstract Freshmen officer cadets in a military university participating in 6 weeks of induction undergo strenuous physical training. Vigorous physical training has been shown to affect red and white blood cell and platelet parameters. Effects have been related to the mode of exercise involved. Since the induction training encompassed various modes of exercise, we studied the effect of physical training on basic anthropometric and hematologic parameters. Twentyseven healthy freshmen officer cadets (13 male and 14 female) joined the study. A blood sample and basic anthropometric measures were collected before and 6 weeks into the induction program. An automated complete blood count was done. Both male and female subjects experienced significant reduction in weight, while only female candidates had lower waist circumference and body mass index (BMI). Red cell count and hemoglobin reduced and mean cell volume (MCV) and mean cell hemoglobin (MCH) increased in the males subjects. Females had lower red cell counts and hemoglobin which was not significantly different, however, their MCV and red cell distribution width (RDW) increased. We conclude that the subjects showed evidence of sports anemia, runners macrocytosis and platelet activation. Raised RDW seen among female participants might indicate poor tolerance in that group. Keywords: Physical activity, exercise, sports physiology, hematological parameters, platelet activation

(Rec.Date: Mar 11, 2014 Accept Date: Mar 31, 2014)

Corresponding Author: Justin Vijay Gnanou, Faculty of Medicine and Defence Health, National Defence University of Malaysia, Kem Sungai Besi, 57000 Kuala Lumpur, Malaysia. Phone: +603-90513027, ext 1018, Fax: +603-9056 5411, E-mail: [email protected] www.medicinescience.org | Med-Science

1479

Medicine Science 2014;3(3):1479-90 Original Investigation

Hematologic Changes and Training doi: 10.5455/medscience.2014.03.8150

Introduction Freshmen joining the National Defence University of Malaysia officer cadets undergo a military induction program of 6 weeks duration. The program prepares them for their new roles by inculcating discipline, loyalty and diligence, providing basic military knowledge and building physical agility, all desirable attributes of a young military officer. Thus the physical training element of the induction program is vital to its success and it is demanding in order to meet the preset goals and targets. Hematologic parameters have been shown to be affected detrimentally by vigorous physical training [1,2]. Twelve weeks of strenuous physical activity resulted in a decrease in hemoglobin concentration as well as increase in platelet count [3], increase in platelet aggregation as well as leukocytosis [4,5]. Although the influence of various types of exercise on hematological indices has been studied, data studying that of military training are scarce. Military training not only encompasses physical fitness and endurance training, it also involves performing specialized activities such handling of weapons and route-marching. A study of the long-term effects (2 years) of Special Forces training on hematological indices describe a significant decrease in hematocrit and red blood cell count when compared with submariners over a similar period. The authors concluded that these hematological changes were due to effect of endurance training [6]. A high platelet count prior to 12 weeks of strenuous physical military training and the subsequent development of low hemoglobin have also been shown [3]. Thus the present study which is the first of its kind in Malaysia; was undertaken to study the effect of 6 weeks of military training on the hematological profile of untrained military university students. Materials and Methods Subjects: Twenty seven healthy subjects (14 male and 13 female) aged 17-21 years were recruited for the study. The students were untrained and newly recruited to the university and participated in the 6-week long induction program conducted by the military training unit of the university. The subjects were healthy, non-smokers and without any previous history of illness, especially hematological disease.

www.medicinescience.org | Med-Science

1480

Medicine Science 2014;3(3):1479-90 Original Investigation

Hematologic Changes and Training doi: 10.5455/medscience.2014.03.8150

Experimental Protocol Approval for this study was obtained from the institutional ethical review committee. Before the study began, the selected subjects were informed about the experimental protocol and an informed consent was obtained from each of them. Baseline anthropometry and body mass index measurements were carried out. Blood samples were collected from the subjects for the measurement of hematological parameters. The subjects then joined the induction program. This military training program conducted by the military training unit of the university is a regimental course and is of 6-weeks duration. It includes basic military training such as intense physical workout, weapons handling, survival training, route-marching along with several other sports activities. Table 1 and 2 give a brief description. During the training program all cadet officers ate a common dining facility and from a common menu. All subjects were required to adhere to this common menu. In order to eliminate the possible impact of dehydration on hematological parameters, the subjects were instructed to drink sufficient water and also to refrain from strenuous exercise during 24 hours prior to collection of blood samples. At the end of the 6-weeks of training, anthropometry, body composition measurements as wells as blood samples for hematological parameters were collected.

Table 1. Description of a typical day Activity Physical training

Duration

Marching Drill

4 hours

Swimming

1 hour

--------------

Sports Lectures and instruction

3 hours

Play sport of choice

1 hour

--------------

Meal, prayer, roll call and free time

7 hours

--------------

Sleep

6 hours

--------------

2 hours

Description Moderate intensity aerobic exercise Marching activities including run and stop, stand and responding to orders

www.medicinescience.org | Med-Science

1481

Medicine Science 2014;3(3):1479-90

Hematologic Changes and Training

Original Investigation

doi: 10.5455/medscience.2014.03.8150

Table 2. Other training Activity

Duration

Basic Jungle training

1 week

Basic weapons training

1 week

Description Basic jungle training activities run through the day for 6 days and include: basic combat skills, leadership training, survival training, navigation (compass marching), rope handling, abseiling, route-marching and river crossing training. Basic weapon training includes marksmanship and weapon handling in total 6 hours a day in addition to the physical training, sports and marching drills

Blood sampling and laboratory analysis Venous blood samples (5ml) were collected in test tubes containing K3EDTA (anticoagulant), and hematological parameters including red blood cell count (RBC), hemoglobin (Hb), hematocrit (Hct), mean red cell volume (MCV), mean red cell hemoglobin (MCH), mean red cell hemoglobin concentration (MCHC), red cell distribution width (RDW), white blood cell (WBC), blood platelets (PLT), mean platelet volume (MPV), platelet distribution width (PDW) and platelet- large cell ratio (p-LCR) were analyzed using a automated cell counter (Sysmex, USA). The data were expressed as mean and standard deviation. In order to determine the effect of 6-weeks of induction training on the hematological parameters before and after the training, Wilcoxon’s signed-rank test was used for differences within groups, with p values < 0.05 considered significant. Data were analyzed on SPSS software version 16.1. Results Male officer cadets experienced a 2.2% reduction in the body weight which was significant. Waist circumference and BMI also reduced, though the changes did not approach statistical significance (Table 3 and 4). Among female officer cadets, body weight, waist circumference and BMI reduced, though these changes were not statistically significant. While total RBC count and hemoglobin concentration reduced significantly, MCV and MCH increased significantly (p